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Relationship between number of different lower-limb resistance exercises prescribed in a program and exercise outcomes in people with knee osteoarthritis : A systematic review with meta-regression

Lawford, Belinda J LU ; Bennell, Kim L ; Spiers, Libby ; Kimp, Alexander J ; Dell'Isola, Andrea LU ; Harmer, Alison R ; Van der Esch, Martin ; Hall, Michelle and Hinman, Rana S (2024) In Arthritis Care and Research
Abstract

OBJECTIVE: Determine whether there is a relationship between the number of different lower-limb resistance exercises prescribed in a program and outcomes for people with knee osteoarthritis.

METHODS: Systematic review with meta-regression. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and Embase up to 4th January 2024. We included randomised controlled trials that evaluated land-based resistance exercise for knee osteoarthritis compared with non-exercise interventions. We conducted meta-regressions between number of different exercises prescribed and standardised mean differences (SMD) for pain and function. Covariates (intervention duration, frequency per week, use of resistance exercise... (More)

OBJECTIVE: Determine whether there is a relationship between the number of different lower-limb resistance exercises prescribed in a program and outcomes for people with knee osteoarthritis.

METHODS: Systematic review with meta-regression. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and Embase up to 4th January 2024. We included randomised controlled trials that evaluated land-based resistance exercise for knee osteoarthritis compared with non-exercise interventions. We conducted meta-regressions between number of different exercises prescribed and standardised mean differences (SMD) for pain and function. Covariates (intervention duration, frequency per week, use of resistance exercise machine/s, and comparator type) were applied to attempt to reduce between-study heterogeneity.

RESULTS: 44 trials (3,364 participants) were included. The number of resistance exercises ranged from 1-12 (mean 5.0; standard deviation 3.0). Meta-regression showed no relationship between the number of prescribed exercises and change in pain (slope coefficient: -0.04 SMD units [95% confidence interval (CI): -0.14 to 0.05) or self-reported function (-0.04 [-0.12 to 0.05]). There was substantial heterogeneity and evidence of publication bias. However, even after removing 31 trials that had overall unclear/high risk of bias, there was no change in relationships.

CONCLUSION: There was no relationship between the number of different lower-limb resistance exercises prescribed in a program and change in knee pain or self-reported function. However, given that we were unable to account for all differences in program intensity, progression, and adherence, as well as the heterogeneity and overall low quality of included studies, our results should be interpreted with caution.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
Arthritis Care and Research
publisher
John Wiley & Sons Inc.
external identifiers
  • pmid:39609070
ISSN
2151-4658
DOI
10.1002/acr.25476
language
English
LU publication?
yes
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This article is protected by copyright. All rights reserved.
id
919bff41-d3bc-48c6-967f-e49a3fd259b9
date added to LUP
2024-11-29 14:15:33
date last changed
2024-11-29 14:15:33
@article{919bff41-d3bc-48c6-967f-e49a3fd259b9,
  abstract     = {{<p>OBJECTIVE: Determine whether there is a relationship between the number of different lower-limb resistance exercises prescribed in a program and outcomes for people with knee osteoarthritis.</p><p>METHODS: Systematic review with meta-regression. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and Embase up to 4th January 2024. We included randomised controlled trials that evaluated land-based resistance exercise for knee osteoarthritis compared with non-exercise interventions. We conducted meta-regressions between number of different exercises prescribed and standardised mean differences (SMD) for pain and function. Covariates (intervention duration, frequency per week, use of resistance exercise machine/s, and comparator type) were applied to attempt to reduce between-study heterogeneity.</p><p>RESULTS: 44 trials (3,364 participants) were included. The number of resistance exercises ranged from 1-12 (mean 5.0; standard deviation 3.0). Meta-regression showed no relationship between the number of prescribed exercises and change in pain (slope coefficient: -0.04 SMD units [95% confidence interval (CI): -0.14 to 0.05) or self-reported function (-0.04 [-0.12 to 0.05]). There was substantial heterogeneity and evidence of publication bias. However, even after removing 31 trials that had overall unclear/high risk of bias, there was no change in relationships.</p><p>CONCLUSION: There was no relationship between the number of different lower-limb resistance exercises prescribed in a program and change in knee pain or self-reported function. However, given that we were unable to account for all differences in program intensity, progression, and adherence, as well as the heterogeneity and overall low quality of included studies, our results should be interpreted with caution.</p>}},
  author       = {{Lawford, Belinda J and Bennell, Kim L and Spiers, Libby and Kimp, Alexander J and Dell'Isola, Andrea and Harmer, Alison R and Van der Esch, Martin and Hall, Michelle and Hinman, Rana S}},
  issn         = {{2151-4658}},
  language     = {{eng}},
  month        = {{11}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Arthritis Care and Research}},
  title        = {{Relationship between number of different lower-limb resistance exercises prescribed in a program and exercise outcomes in people with knee osteoarthritis : A systematic review with meta-regression}},
  url          = {{http://dx.doi.org/10.1002/acr.25476}},
  doi          = {{10.1002/acr.25476}},
  year         = {{2024}},
}